Individual provider Active NPI

Ayleen Annette Augustine, D.C.

  • Chiropractor
  • San Jose, CA
National Provider Identifier
1457420010
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 29586 Issued in CA
Practice address
1460 Koll Cir
Suite C
San Jose, CA 95112-4616
Phone
(408) 313-7641
NPI assigned
Nov 7, 2006
Last updated
Jun 18, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 29586 CA Primary

Addresses

Primary practice location

1460 Koll Cir
Suite C
San Jose, CA 95112-4616

Mailing address

1460 Koll Cir
Suite C
San Jose, CA 95112-4616
Phone (408) 313-7641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 29586CAMDChiropractor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1457420010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 KOLL CIR",
            "address_2": "SUITE C",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124616",
            "telephone_number": "408-313-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 KOLL CIR",
            "address_2": "SUITE C",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951124616",
            "telephone_number": "408-313-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "AYLEEN",
        "middle_name": "ANNETTE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 29586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.